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H.R. 5800: Medicaid Institutes for Mental Disease Are Decisive in Delivering Inpatient Treatment for Individuals but Opportunities for Needed Access are Limited without Information Needed about Facility Obligations Act

H.R. 5800 directs the Medicaid and CHIP Payment and Access Commission (MACPAC) to conduct a study on institutions for mental disease that receive Medicaid reimbursement. The study shall report on the requirements and standards that state Medicaid programs have in place for institutions for mental diseases (IMD). MACPAC shall summarize the findings and make recommendations on best practices and data collection no later than January 2020.

The Medicaid and CHIP Payment and Access Commission (MACPAC) is a non-partisan legislative branch agency that provides policy and data analysis and makes recommendations to Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on a wide array of issues affecting Medicaid and the State Children’s Health Insurance Program (CHIP). The U.S. Comptroller General appoints MACPAC’s 17 commissioners, who come from diverse regions across the United States and bring broad expertise and a wide range of perspectives on Medicaid and CHIP. MACPAC serves as an independent source of information on Medicaid and CHIP, publishing issue briefs and data reports throughout the year to support policy analysis and program accountability.

The term 'institution for mental diseases' means a hospital, nursing facility, or other institution of more than 16 beds, that is primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases, including medical attention, nursing care, and related services. Under current law, the federal government is prohibited from providing Medicaid matching funds to states for services rendered to Medicaid-eligible individuals aged 21 to 64 who are patients in IMDs. The term mental disease includes substance abuse disorders, such as opioid use disorder.

Last updated Jun 12, 2018. Source: Republican Policy Committee

The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on Jun 12, 2018.


Medicaid Institutes for Mental Disease Are Decisive in Delivering Inpatient Treatment for Individuals but Opportunities for Needed Access are Limited without Information Needed about Facility Obligations Act or the Medicaid IMD ADDITIONAL INFO Act

(Sec. 2) This bill requires the Medicaid and Children's Health Insurance Program (CHIP) Payment and Access Commission to report on information relating to services for Medicaid enrollees who are patients in institutions for mental diseases (IMDs), including: (1) the number and type of IMDs in each sampled state and associated coverage limitations, (2) services and processes provided at such IMDs, (3) applicable federal waivers and other Medicaid funding sources for such IMDs, (4) state requirements for such IMDs to receive funding, and (5) recommendations to improve standards and data collection for IMDs.